psychologywikiaorg-20200213-history
Dehydration
| ICD9 = | }} Dehydration (hypohydration) is the removal of water (hydro in ancient Greek) from an object. Medically, condition in which the body contains an insufficient volume of water for normal functioning. Medical causes of dehydration in humans In humans, dehydration can be caused by a wide range of diseases and states that impair water homeostasis in the body. These include: * External or stress-related causes ** Prolonged physical activity without consuming adequate water, especially in a hot environment ** Prolonged exposure to dry air, e.g., in high-flying airplanes (5-15% r.h.) ** Survival situations, especially desert survival conditions ** Blood loss or hypotension due to physical trauma ** Diarrhea ** Hyperthermia ** Shock (hypovolemic) ** Vomiting ** Burns * Infectious diseases ** Cholera ** Gastroenteritis ** Shigellosis ** Yellow fever * Malnutrition ** Electrolyte imbalance *** Hypernatremia (also caused by dehydration) *** Hyponatremia, especially from restricted salt diets ** Consumption of alcohol, caffeine or other diuretic substances. ** Fasting ** Recent rapid weight loss may reflect progressive depletion of fluid volume. (The loss of 1 L of fluid results in a weight loss of 1 kg, or 2.2 lb.)http://www.heartspring.net/symptoms_of_dehydration.html ** Patient refusal of nutrition and hydration * Other causes of obligate water loss ** Severe hyperglycemia, especially in Diabetes mellitus *** Glycosuria Other causes Alcohol abuse Exercise Dehydration refers both to hypohydration (dehydration induced prior to exercise) and to exercise-induced dehydration (dehydration that develops during exercise). The latter reduces aerobic endurance performance and results in increased body temperature, heart rate, perceived exertion, and possibly increased reliance on carbohydrate as a fuel source. Although the negative effects of exercise-induced dehydration on exercise performance were clearly demonstrated in the 1940s, athletes continued to believe for years thereafter that fluid intake was not beneficial. More recently, negative effects on performance have been demonstrated with modest (<2%) dehydration, and these effects are exacerbated when the exercise is performed in a hot environment. The effects of hypohydration may vary, depending on whether it is induced through diuretics or sauna exposure, which substantially reduce plasma volume, or prior exercise, which has much less impact on plasma volume. Hypohydration reduces aerobic endurance, but its effects on muscle strength and endurance are not consistent and require further study. Intense prolonged exercise produces metabolic waste heat, and this is removed by sweat-based thermoregulation. A male marathon runner loses each hour around 0.83 L in cool weather and 1.2 L in warm (losses in females are about 68 to 73% lower).Cheuvront SN, Haymes EM. (2001) Thermoregulation and marathon running: biological and environmental influences. Sports Med. 31:743-62. People doing heavy exercise may lose two and half times as much fluid in sweat as urine. This can have profound physiological effects. Cycling for 2 hours in the heat (35 °C) with minimal fluid intake causes body mass decline by 3 to 5%, blood volume likewise by 3 to 6%, body temperature to rise constantly, and in comparison with proper fluid intake, higher heart rates, lower stroke volumes and cardiac outputs, reduced skin blood flow, and higher systemic vascular resistance. These effects are largely eliminated by replacing 50 to 80% of the fluid lost in sweat. Symptoms and prognosis Symptoms may include headaches similar to what is experienced during a hangover, a sudden episode of visual snow, decreased blood pressure (hypotension), and dizziness or fainting when standing up due to orthostatic hypotension. Untreated dehydration generally results in delirium, unconsciousness, and in extreme cases death. Dehydration symptoms generally become noticeable after 2% of one's normal water volume has been lost. Initially, one experiences thirst and discomfort, possibly along with loss of appetite and dry skin.This can be followed by constipation. Athletes may suffer a loss of performance of up to 50%, and experience flushing, low endurance, rapid heart rates, elevated body temperatures, and rapid onset of fatigue. Symptoms of mild dehydration include thirst, decreased urine volume, urine that is darker than usual, unexplained tiredness, lack of tears when crying, headache, dry mouth, and dizziness when standing due to orthostatic hypotension. In moderate to severe dehydration, there may be no urine output at all. Other symptoms in these states include lethargy or extreme sleepiness, seizures, sunken fontanel (soft spot) in infants, fainting, and sunken eyes. The symptoms become increasingly severe with greater water loss. One's heart and respiration rates begin to increase to compensate for decreased plasma volume and blood pressure, while body temperature may rise because of decreased sweating. Around 5% to 6% water loss, one may become groggy or sleepy, experience headaches or nausea, and may feel tingling in one's limbs (paresthesia). With 10% to 15% fluid loss, muscles may become spastic, skin may shrivel and wrinkle, vision may dim, urination will be greatly reduced and may become painful, and delirium may begin. Losses greater than 15% are usually fatal. http://faculty.washington.edu/kepeter/118/notes/water_balance.htm Cognitive effects of dehydration Dehydration in the elderly Treatment . Courtesy:Centers for Disease Control and Prevention]] The best treatment for minor dehydration is drinking water and stopping fluid loss. Water is preferable to sport drinks and other commercially-sold rehydration fluids, as the balance of electrolytes they provide may not match the replacement requirements of the individual. To stop fluid loss from vomiting and diarrhea, avoid solid foods and drink only clear liquids."Healthwise Handbook," Healthwise, Inc., 1999 In more severe cases, correction of a dehydrated state is accomplished by the replenishment of necessary water and electrolytes (rehydration, through oral rehydration therapy or intravenous therapy). Even in the case of serious lack of fresh water (e.g., at sea or in a desert), drinking seawater or urine does not help, nor does the consumption of alcohol. It is often thought that the sudden influx of salt into the body from seawater will cause the cells to dehydrate and the kidneys to overload and shut down but it has been calculated that average adult can drink up to 0.2 liters of seawater per day before the kidneys start to fail. When dehydrated, unnecessary sweating should be avoided, as it wastes water. If there is only dry food, it is better not to eat, as water is necessary for digestion. For severe cases of dehydration where fainting, unconsciousness, or any other severely inhibiting symptom is present (the patient is incapable of standing or thinking clearly), emergency attention is required. Fluids containing a proper balance of replacement electrolytes are given orally or intravenously with continuing assessment of electrolyte status; complete resolution is the norm in all but the most extreme cases. Avoiding dehydration Dehydration is best avoided by drinking plenty of water. The greater the amount of water lost through perspiration, the more water must be consumed to replace it and avoid dehydration. Since the body cannot tolerate large deficits or excesses in total body water, consumption of water must be roughly concurrent with the loss (in other words, if one is perspiring, one should also be drinking water frequently). Drinking water slightly beyond the needs of the body entails no risk, since the kidneys will efficiently remove any excess water through the urine with a large margin of safety. A person's body, during an average day in a temperate climate such as the United Kingdom, loses approximately 2.5 liters of water. This can be through the lungs as water vapor, through the skin as sweat, or through the kidneys as urine. Some water (a less significant amount, in the absence of diarrhea) is also lost through the bowels. In warm or humid weather or during heavy exertion, however, the water loss can increase by an order of magnitude or more through perspiration—all of which must be promptly replaced. In extreme cases, the losses may be great enough to exceed the body's ability to absorb water from the gastrointestinal tract; in these cases, it is not possible to drink enough water to stay hydrated, and the only way to avoid dehydration is to reduce perspiration (through rest, a move to a cooler environment, etc.). A useful rule of thumb for avoiding dehydration in hot or humid environments or during strenuous activity involves monitoring the frequency and character of urination. If one develops a full bladder at least every 3-5 hours and the urine is only lightly colored or colorless, chances are that dehydration is not occurring; if urine is deeply colored, or urination occurs only after many hours or not at all, water intake may not be adequate to maintain proper hydration. When large amounts of water are being lost through perspiration and concurrently replaced by drinking, maintaining proper electrolyte balance becomes an issue. Drinking fluids that are hypertonic or hypotonic with respect to perspiration may have grave consequences (hyponatremia or hypernatremia, principally) as the total volume of water turnover increases. If water is being lost through abnormal mechanisms such as vomiting or diarrhea, that carry away electrolytes in large quantities, an imbalance can develop very quickly into a medical emergency. In fact, the main mechanisms through which diseases such as infantile diarrhea and cholera kill their victims are dehydration and loss of electrolytes. See also * Homeostasis * Hypovolemia, a depletion of blood volume that can be caused by dehydration * Terminal dehydration * Water deprivation * Water intake * Water intoxication References Further reading *Abdulla, R. A. (2004). Entertainment-Education in the Middle East: Lessons From the Egyptian Oral Rehydration Therapy Campaign. Mahwah, NJ: Lawrence Erlbaum Associates Publishers. *Adam, G. E., Carter, R., III, Cheuvront, S. N., Merullo, D. J., Castellani, J. W., Lieberman, H. R., et al. (2008). Hydration effects on cognitive performance during military tasks in temperate and cold environments: Physiology & Behavior Vol 93(4-5) Mar 2008, 748-756. *Albert, S. G., Nakra, B. R., Grossberg, G. T., & Caminal, E. R. (1989). Vasopressin response to dehydration in Alzheimer's disease: Journal of the American Geriatrics Society Vol 37(9) Sep 1989, 843-847. *Albert, S. G., Nakra, B. R. S., Grossberg, G. T., & Caminal, E. R. (1994). Drinking behavior and vasopressin responses to hyperosmolality in Alzheimer's disease: International Psychogeriatrics Vol 6(1) Spr 1994, 79-86. *Alvarez Larrauri, S., Alvarez Larrauri, C., & Jufresa Carreras, J. (1994). Learning to prevent dehydration in distant Mexican communities and markets: Social Science & Medicine Vol 38(11) Jun 1994, 1499-1507. *Amos, D., Hansen, R., Lau, W.-M., & Michalski, J. T. (2000). Physiological and cognitive performance of soldiers conducting routine patrol and reconnaissance operations in the tropics: Military Medicine Vol 165(12) Dec 2000, 961-966. *Andrade, C. A. F., De Luca, L. A., Jr., Colombari, D. S. A., & Menani, J. V. (2007). Enhancement of meal-associated hypertonic NaCl intake by moxonidine into the lateral parabrachial nucleus: Behavioural Brain Research Vol 183(2) Nov 2007, 156-160. *Barney, C. C., Kurylo, D. M., & Grobe, J. (2003). Thermal dehydration-induced thirst in lithium-treated rats: Pharmacology, Biochemistry and Behavior Vol 75(2) May 2003, 341-347. *Barney, C. C., Morrison, C. M., Renkema, L.-A., & Vergoth, C. (1992). Opioid modulation of thermal dehydration-induced thirst in rats: Pharmacology, Biochemistry and Behavior Vol 43(4) Dec 1992, 1065-1070. *Bartley, S. H., & Chute, E. (1947). Temperature extremes and water and salt lacks. New York, NY: McGraw-Hill Book Company. *Bhat, M. A., Kawoosa, M. S., Bhat, J. I., & Ali, W. (2008). Hypernatremia and intracranial complications due to inadequate exclusive breast-feed in neonates: Journal of Pediatric Neurology Vol 6(2) 2008, 183-187. *Blau, J. N., Kell, C. A., & Sperling, J. M. (2004). Water-Deprivation Headache: A New Headache With Two Variants: Headache: The Journal of Head and Face Pain Vol 44(1) Jan 2004, 79-83. *Brink, A. L., Jeppesen, L. L., & Heller, K. E. (2004). Behaviour in suckling mink kits under farm conditions: Effects of accessibility of drinking water: Applied Animal Behaviour Science Vol 89(1-2) Nov 2004, 131-137. *Brunstrom, J. M., MacRae, A. W., & Roberts, B. (1997). Mouth-state dependent changes in the judged pleasantness of water at different temperatures: Physiology & Behavior Vol 61(5) May 1997, 667-669. *Burge, F. I. (1993). Dehydration symptoms of palliative care cancer patients: Journal of Pain and Symptom Management Vol 8(7) Oct 1993, 454-464. *Butudom, P., Axiak, S. M., Nielsen, B. D., Eberhart, S. W., & Schott, H. C., II. (2003). Effects of varying initial drink volume on rehydration of horses: Physiology & Behavior Vol 79(2) Jul 2003, 135-142. *Byock, IR, M.D.,(1995) Patient Refusal of Nutrition and Hydration: Walking the Ever-Finer Line. American Journal Hospice & Palliative Care, pp. 8-13. *Callahan, J. B., & Rinaman, L. (1998). The postnatal emergence of dehydration anorexia in rats is temporally associated with the emergence of dehydration-induced inhibition of gastric emptying: Physiology & Behavior Vol 64(5) Jul 1998, 683-687. *Changizi, M. A., McGehee, R. M. F., & Hall, W. G. (2002). Evidence that appetitive responses for dehydration and food-deprivation are learned: Physiology & Behavior Vol 75(3) Mar 2002, 295-304. *Christensen, R. C., & McCrary, S. V. (1995). Treatment refusal by an elderly man suffering intensely from treatment-resistant depression: Psychiatric Services Vol 46(2) Feb 1995, 181-183. *Cian, C., Barraud, P. A., Melin, B., & Raphel, C. (2001). Effects of fluid ingestion on cognitive function after heat stress or exercise-induced dehydration: International Journal of Psychophysiology Vol 42(3) Nov 2001, 243-251. *Cian, C., Koulmann, N., Barraud, P. A., Raphel, C., Jimenez, C., & Melin, B. (2000). Influences of variations in body hydration on cognitive function: Effect of hyperhydration, heat stress, and exercise-induced dehydration: Journal of Psychophysiology Vol 14(1) 2000, 29-36. *David, R. B., Menani, J. V., & De Luca, L. A., Jr. (2008). Serotonergic receptor blockade in the lateral parabrachial nucleus: Different effects on hypertonic and isotonic NaCl intake: Brain Research Vol 1187 Jan 2008, 137-145. *de Araujo Cintra, E., Araujo, S., Quagliato, E. M. A. B., de Castro, M., Falcao, A. L. E., Dragosavac, D., et al. (2007). Vasopressin serum levels and disorders of sodium and water balance in patients with severe brain injury: Arquivos de Neuro-Psiquiatria Vol 65(4-B) Dec 2007, 1158-1165. *De Castro--Silva, E., Sarmento, C., Nascimento, T. A., Luz, C. P., Soares, T., Marinho, C. A., et al. (1997). Effects of third ventricle administration of L-694,247, a selective 5-HT1-sub(D ) receptor agonist, on water intake in rats: Pharmacology, Biochemistry and Behavior Vol 57(4) Aug 1997, 749-754. *De Luca, L. A., Jr., Vendramini, R. C., Pereira, D. T. B., Colombari, D. A. S., David, R. B., de Paula, P. M., et al. (2007). Water deprivation and the doubledepletion hypothesis: Common neural mechanisms underlie thirst and salt appetite: Brazilian Journal of Medical and Biological Research Vol 40(5) May 2007, 707-712. *Doi, N., & Toh, Y. (1992). Modification of cockroach behavior to environmental humidity change by dehydration (Dictyoptera: Blattidae): Journal of Insect Behavior Vol 5(4) Jul 1992, 479-490. *Duchene, P. M., & LeSage, J. (1990). Hydration and nutrition. New York, NY: Springer Publishing Co. *Eckel, L. A., & Ossenkopp, K.-P. (1995). Cholecystokinin reduces ingestive taste reactivity responses to water in fluid-replete but not fluid-deprived rats: Physiology & Behavior Vol 57(3) Mar 1995, 599-603. *Edvardsson, M. (2007). Female Callosobruchus maculatus mate when they are thirsty: Resource-rich ejaculates as mating effort in a beetle: Animal Behaviour Vol 74(2) Aug 2007, 183-188. *Eisemon, T. O., Patel, V. L., & Sena, S. O. (1987). Uses of formal and informal knowledge in the comprehension of instructions for oral rehydration therapy in Kenya: Social Science & Medicine Vol 25(11) 1987, 1225-1234. *Engell, D. B., Maller, O., Sawka, M. N., Francesconi, R. N., & et al. (1987). Thirst and fluid intake following graded hypohydration levels in humans: Physiology & Behavior Vol 40(2) 1987, 229-236. *Fainsinger, R. L., MacEachern, T., Miller, M. J., Bruera, E., & et al. (1994). The use of hypodermoclysis for rehydration in terminally ill cancer patients: Journal of Pain and Symptom Management Vol 9(5) Jul 1994, 298-302. *Fitzgerald, B., Middleton, J. K., & Cooper, S. A. (1997). Adverse effects of summer amongst people with learning disabilities: Neuroleptic malignant syndrome: Journal of Intellectual Disability Research Vol 41(3) Jun 1997, 273-277. *Flynn, F. W., Curtis, K. S., Verbalis, J. G., & Stricker, E. M. (1995). Dehydration anorexia in decerebrate rats: Behavioral Neuroscience Vol 109(5) Oct 1995, 1009-1012. *Forsyth, D. M., Lapid, M. I., Ellenbecker, S. M., Smith, L. K., O'Neil, M. L., Low, D. J., et al. (2008). Hydration status of geriatric patients in a psychiatric hospital: Issues in Mental Health Nursing Vol 29(8) Aug 2008, 853-862. *Fregly, M. J., Greenleaf, J. E., & Rowland, N. E. (1986). Effect of intraperitoneal and intragastric loading with water and isosmotic solutions of saline and glucose on water intake of dehydrated rats: Brain Research Bulletin Vol 16(3) Mar 1986, 415-420. *Fregoneze, J. B., Cunha, M., Bulcao, C., Ferreira, H., & et al. (1994). Acute effect of intracerebroventricular administration of lead on the drinking behavior of rats induced by dehydration or central cholinergic and angiotensinergic stimulation: Physiology & Behavior Vol 56(1) Jul 1994, 129-133. *Fries, B. E., Hawes, C., Morris, J. N., & Phillips, C. D. (1997). Effect of the National Resident Assessment Instrument on selected health conditions and problems: Journal of the American Geriatrics Society Vol 45(8) Aug 1997, 994-1001. *Ganzini, L., Goy, E. R., Miller, L. L., Harvath, T. A., Jackson, A., & Delorit, M. A. (2003). Nurses' Experiences with Hospice Patients Who Refuse Food and Fluids to Hasten Death: New England Journal of Medicine Vol 349(4) Jul 2003, 359-365. *Godkin, D. (2003). "Reducing hydration-linked events in nursing home residents": Commentary: Clinical Nursing Research Vol 12(3) Aug 2003, 226-228. *Guegan, A., Bandzouzi, B., Sauvage, P., Buia, J. M., & et al. (1993). Delirium and hydration disorders in a gerontology department: Psychologie Medicale Vol 25(Spec Issue 8) 1993, 772-774. *Hall, W. G. (1989). Neural systems for early independent ingestion: Regional metabolic changes during ingestive responding and dehydration: Behavioral Neuroscience Vol 103(2) Apr 1989, 386-411, 453-463. *Hall, W. G., Arnold, H. M., & Myers, K. P. (2000). The acquisition of an appetite: Psychological Science Vol 11(2) Mar 2000, 101-105. *Harikai, N., Tomogane, K., Sugawara, T., & Tashiro, S.-i. (2003). Differences in hypothalamic Fos expressions between two heat stress conditions in conscious mice: Brain Research Bulletin Vol 61(6) Oct 2003, 617-626. *Hatta, K., Takahashi, T., Nakamura, H., Yamashiro, H., Endo, H., Fujii, S., et al. (1998). Abnormal physiological conditions in acute schizophrenia patients on emergency admission: Dehydration, hypokalemia, leukocytosis and elevated serum muscle enzymes: European Archives of Psychiatry and Clinical Neuroscience Vol 248(4) 1998, 180-188. *Henry, R. P., McBride, C. J., & Williams, A. H. (1993). Responses of the marsh periwinkle, Littoraria (Littorina) irrorata to temperature, salinity and desiccation, and the potential physiological relationship to climbing behavior: Marine and Freshwater Behaviour and Physiology Vol 24(1) Nov 1993, 45-54. *Hiyama, T. Y., Watanabe, E., Okado, H., & Noda, M. (2004). The Subfornical Organ is the Primary Locus of Sodium-Level Sensing by Na-sub(x) Sodium Channels for the Control of Salt-Intake Behavior: Journal of Neuroscience Vol 24(42) 2004, 9276-9281. *Inouye, S. K. (1999). "A multicomponent intervention to prevent delirium in hospitalized older patients": Reply: New England Journal of Medicine Vol 341(5) Jul 1999, 370. *Inouye, S. K., Bogardus, S. T., Charpentier, P. A., Leo-Summers, L., Acampora, D., Holford, T. R., et al. (1999). A multicomponent intervention to prevent delirium in hospitalized older patients: New England Journal of Medicine Vol 340(9) Mar 1999, 669-676. *Jackson, R. E., Cockram, M. S., Goddard, P. J., Doherty, O. M., McGilp, I. M., & Waran, N. K. (1999). The effects of 24h water deprivation when associated with some aspects of transportation on the behaviour and blood chemistry of sheep: Animal Welfare Vol 8(3) 1999, 229-241. *Jacobs, S. (2003). Death by Voluntary Dehydration -- What the Caregivers Say: New England Journal of Medicine Vol 349(4) Jul 2003, 325-326. *Jaimes-Hoy, L., Joseph-Bravo, P., & de Gortari, P. (2008). Differential response of TRHergic neurons of the hypothalamic paraventricular nucleus (PVN) in female animals submitted to food-restriction or dehydration-induced anorexia and cold exposure: Hormones and Behavior Vol 53(2) Feb 2008, 366-377. *Janovic, S., Janovic, M. B., & Stojanovic, M. (2007). Acute lithium intoxication due to dehydration - A case report: Socijalna Psihijatrija Vol 35(2) Jun 2007, 99-102. *Joosten, E., Lemiengre, J., Nelis, T., Verbeke, G., & Milisen, K. (2006). Is Anaemia a Risk Factor for Delirium in an Acute Geriatric Population? : Gerontology Vol 52(6) 2006, 382-385. *Kamikawa, H., Katafuchi, T., Hosoi, M., Yamamoto, T., & Hori, T. (1999). Hyperalgesic response to noxious stimulation in genetically polydipsic mice: Brain Research Vol 846(2) Nov 1999, 171-176. *Kayser-Jones, J. (2002). Malnutrition, dehydration, and starvation in the midst of plenty: The political impact of qualitative inquiry: Qualitative Health Research Vol 12(10) Dec 2002, 1391-1405. *Klemm, W. R., & Yurttas, L. (1992). The dehydration theory of alcohol intoxication: Relevance to treatment issues. Totowa, NJ: Humana Press. *Koopmans, R. T. C. M., van der Sterren, K. J. M. A., & van der Steen, J. T. (2007). The 'natural' endpoint of dementia: Death from cachexia or dehydration following palliative care? : International Journal of Geriatric Psychiatry Vol 22(4) Apr 2007, 350-355. *Kostinsky, S., Miller, K., & Stewart, C. N. (2000). Sodium detection during the water absorption response in Rana pipiens: Physiology & Behavior Vol 68(3) Jan 2000, 373-376. *Kraly, F. S. (1990). Pregastric food-contingent stimulation elicits drinking in the absence of systemic dehydration in the rat: Physiology & Behavior Vol 48(6) Dec 1990, 841-844. *Landers, D. M., Arent, S. M., & Lutz, R. S. (2001). Affect and cognitive performance in high school wrestlers undergoing rapid weight loss: Journal of Sport & Exercise Psychology Vol 23(4) Dec 2001, 307-316. *Leff, B. (1999). "A multicomponent intervention to prevent delirium in hospitalized older patients": Comment: New England Journal of Medicine Vol 341(5) Jul 1999, 369. *Leshem, M. (1998). Salt preference in adolescence is predicted by common prenatal and infantile mineralofluid loss: Physiology & Behavior Vol 63(4) Apr 1998, 699-704. *Liben, S. (1996). Pediatric palliative medicine: Obstacles to overcome: Journal of Palliative Care Vol 12(3) Fal 1996, 24-28. *Lieberman, H. R., Bathalon, G. P., Falco, C. M., Kramer, F. M., Morgan, C. A., III, & Niro, P. (2005). Severe Decrements in Cognition Function and Mood Induced by Sleep Loss, Heat, Dehydration, and Undernutrition During Simulated Combat: Biological Psychiatry Vol 57(4) Feb 2005, 422-429. *Liu, H., Terrell, M. L., Bui, V., Summy-Long, J. Y., & Kadekaro, M. (1998). Nitric oxide control of drinking, vasopressin and oxytocin release and blood pressure in dehydrated rats: Physiology & Behavior Vol 63(5) Mar 1998, 763-769. *Loughridge, J. L., & Barratt, J. (2005). Does the provision of cooled filtered water in secondary school cafeterias increase water drinking and decrease the purchase of soft drinks? : Journal of Human Nutrition and Dietetics Vol 18(4) Aug 2005, 281-286. *MacDonald, S. E., Moralejo, D. G., & Matthews, M. K. (2005). Correct preparation and administration of oral rehydration solution: Essential for safe and effective home treatment of diarrhea in Indonesia: International Quarterly of Community Health Education Vol 24(3) 2005-2006, 205-214. *Mann, K., Mundle, G., Langle, G., & Petersen, D. (1993). The reversibility of alcoholic brain damage is not due to rehydration: A CT study: Addiction Vol 88(5) May 1993, 649-653. *Mantella, R. C., Vollmer, R. R., & Amico, J. A. (2005). Corticosterone release is heightened in food or water deprived oxytocin deficient male mice: Brain Research Vol 1058(1-2) Oct 2005, 56-61. *Massi, M., de Caro, G., Mazzarella, L., & Epstein, A. N. (1986). The role of the subfornical organ in the drinking behavior of the pigeon: Brain Research Vol 381(2) Sep 1986, 289-299. *Matthews, S. G., & Parrott, R. F. (1991). Centrally administered atriopeptin III reduces water intake and vasopressin secretion in dehydrated sheep: Peptides Vol 12(1) Jan-Feb 1991, 77-79. *McCallum, K., Bermudez, O., Ohlemeyer, C., Tyson, E., Portilla, M., & Ferdman, B. (2006). How Should the Clinician Evaluate and Manage the Cardiovascular Complications of Anorexia Nervosa? : Eating Disorders: The Journal of Treatment & Prevention Vol 14(1) Jan-Feb 2006, 73-80. *McKinley, M. J., Denton, D. A., Thomas, C. J., Woods, R. L., & Mathai, M. L. (2006). Differential effects of aging on fluid intake in response to hypovolemia, hypertonicity, and hormonal stimuli in Munich Wistar rats: PNAS Proceedings of the National Academy of Sciences of the United States of America Vol 103(9) Feb 2006, 3450-3455. *Mentes, J. C. (2008). Managing oral hydration. New York, NY: Springer Publishing Co. *Mentes, J. C., & Culp, K. (2003). Reducing hydration-linked events in nursing home residents: Clinical Nursing Research Vol 12(3) Aug 2003, 210-225. *Meyer, L. G., Horrigan, D. J., & Lotz, W. G. (1995). Effects of three hydration beverages on exercise performance during 60 hours of heat exposure: Aviation, Space, and Environmental Medicine Vol 66(11) Nov 1995, 1052-1057. *Myers, K. P., & Hall, W. G. (2001). Effects of prior experience with dehydration and water on the time course of dehydration-induced drinking in weanling rats: Developmental Psychobiology Vol 38(3) Apr 2001, 145-153. *Neave, N., Scholey, A. B., Emmett, J. R., Moss, M., Kennedy, D. O., & Wesnes, K. A. (2001). Water ingestion improves subjective alertness, but has no effect on cognitive performance in dehydrated healthy young volunteers: Appetite Vol 37(3) Dec 2001, 255-256. *Nozaki, P. N., Pereira, D. T. B., Moura, F. V., Menani, J. V., & De Luca, L. A., Jr. (2002). Ingestion of hypertonic NaCl vs. palatable drinks by sodium-depleted rats: Physiology & Behavior Vol 75(4) Apr 2002, 443-448. *Osborne, P. G., Denton, D. A., & Weisinger, R. S. (1987). Inhibition of dehydration induced drinking in rats by reduction of CSF Na concentration: Brain Research Vol 412(1) May 1987, 36-42. *Ozbek, A., Kumral, A., Guvenir, T., Tas, F. V., Gencer, O., Duman, N., et al. (2008). Maternal psychosocial aspects in hypernatremic dehydration with high sodium concentrations in breast milk: A case-control study: Journal of Paediatrics and Child Health Vol 44(1-2) Jan 2008, 38-43. *Patch, C. S., Mason, S., Curcio-Borg, F., & Tapsell, L. C. (2003). Thickened Fluids: Factors Affecting Wastage: Advances in Speech Language Pathology Vol 5(2) Sep 2003, 73-77. *Patel, A. V., Mihalik, J. P., Notebaert, A. J., Guskiewicz, K. M., & Prentice, W. E. (2007). Neuropsychological performance, postural stability, and symptoms after dehydration: Journal of Athletic Training Vol 42(1) Jan-Mar 2007, 66-75. *Patel, V. L., Eisemon, T. O., & Arocha, J. F. (1990). Comprehending instructions for using pharmaceutical products in rural Kenya: Instructional Science Vol 19(1) 1990, 71-84. *Paulsen, S. J., Christensen, M. T., Vrang, N., & Larsen, L. K. (2008). The putative neuropeptide TAFA5 is expressed in the hypothalamic paraventricular nucleus and is regulated by dehydration: Brain Research Vol 1199 Mar 2008, 1-9. *Pereira, D. T. B., David, R. B., Vendramini, R. C., Menani, J. V., & De Luca, L. A., Jr. (2005). Potassium intake during cell dehydration: Physiology & Behavior Vol 85(2) Jun 2005, 99-106. *Pereira, D. T. B., Vendramini, R. C., David, R. B., Nozaki, P. N., Menani, J. V., & De Luca, L. A., Jr. (2002). Isotonic NaCl intake by cell-dehydrated rats: Physiology & Behavior Vol 76(4-5) Aug 2002, 501-505. *Phifer, C. B., Denzinger, A., & Hall, W. G. (1991). The early presence of food-oriented appetitive behavior in developing rats: Developmental Psychobiology Vol 24(7) Nov 1991, 453-461. *Phifer, C. B., Ladd, M. D., & Hall, W. G. (1991). Effects of hydrational state on ingestion in infant rats: Is dehydration the only ingestive stimulus? : Physiology & Behavior Vol 49(4) Apr 1991, 695-699. *Polidori, C., Panocka, I., Perfumi, M., Pompei, P., & et al. (1992). Inhibition of cell dehydration-induced drinking by tachykinins: Evaluation of possible renal effects accounting for the long-lasting inhibition: Physiology & Behavior Vol 52(1) Jul 1992, 153-158. *Pool, R. (2004). 'You're not going to dehydrate mom, are you?": Euthanasia, versterving, and good death in the Netherlands: Social Science & Medicine Vol 58(5) Mar 2004, 955-966. *Portnoi, V. A., Redling, T., & Amesty, S. C. (1999). "A multicomponent intervention to prevent delirium in hospitalized older patients": Comment: New England Journal of Medicine Vol 341(5) Jul 1999, 369. *Ramsay, D. J., & Booth, D. A. (1991). Thirst: Physiological and psychological aspects. New York, NY: Springer-Verlag Publishing. *Rolls, B. J. (1989). Regulation of food and fluid intake in the elderly. New York, NY: New York Academy of Sciences. *Roozen, H. G., de Kan, R., van den Brink, W., Kerkhof, A. J. F. M., & Geerlings, P. J. (2002). Dangers involved in rapid opioid detoxification while using opioid antagonists: Dehydration and renal failure: Addiction Vol 97(8) Aug 2002, 1071-1073. *Rosenthal, R. R. (1989). Physiology of exercise-induced asthma. San Diego, CA: Academic Press. *Rowland, N. E. (2004). The vagus nerve and thirst: Physiology & Behavior Vol 82(1) Aug 2004, 75-80. *Rowland, N. E. (2005). Drinking. New York, NY: Oxford University Press. *Salisbury, J. J., & Rowland, N. E. (1990). Sham drinking in rats: Osmotic and volumetric manipulations: Physiology & Behavior Vol 47(4) Apr 1990, 625-630. *Satoh, M., Sakuda, H., Kobayashi, T., Kataoka, T., Nakao, F., & Turale, S. (2007). Comparison of the body fluid levels in healthy individuals and those with schizophrenia in Japan: Using the bioelectrical impedance method: Nursing & Health Sciences Vol 9(3) Sep 2007, 177-184. *Schwartz, C. E. (1999). "A multicomponent intervention to prevent delirium in hospitalized older patients": Comment: New England Journal of Medicine Vol 341(5) Jul 1999, 369-370. *Schwarz, J. (2007). Exploring the option of voluntarily stopping eating and drinking within the context of a suffering patient's request for a hastened death: Journal of Palliative Medicine Vol 10(6) Dec 2007, 1288-1297. *Simmons, S. F., Alessi, C., & Schnelle, J. F. (2001). An intervention to increase fluid intake in nursing home residents: Prompting and preference compliance: Journal of the American Geriatrics Society Vol 49(7) Jul 2001, 926-933. *Snyder, B. D. (1999). "A multicomponent intervention to prevent delirium in hospitalized older patients": Comment: New England Journal of Medicine Vol 341(5) Jul 1999, 370. *Spangler, A. A., & Chidester, J. C. (1998). Age, dependency and other factors influencing fluid intake by long term care residents: Journal of Nutrition for the Elderly Vol 18(2) 1998, 21-35. *Spigt, M. G., Knottnerus, J. A., Westerterp, K. R., Rikkert, M. G. M. O., & van Schayck, C. P. (2006). The Effects of 6 Months of Increased Water Intake on Blood Sodium, Glomerular Filtration Rate, Blood Pressure, and Quality of Life in Elderly (Aged 55-75) Men: Journal of the American Geriatrics Society Vol 54(3) Mar 2006, 438-443. *Stricker, E. M., & Sved, A. F. (2002). Controls of vasopressin secretion and thirst: Similarities and dissimilarities in signals: Physiology & Behavior Vol 77(4-5) Dec 2002, 731-736. *Suarez de Balcazar, Y., & Balcazar, F. E. (1991). Child survival in the Third World: A functional analysis of oral rehydration therapy dissemination campaigns: Behaviour Change Vol 8(1) 1991, 26-34. *Suhr, J. A., Hall, J., Patterson, S. M., & Niinisto, R. T. (2004). The relation of hydration status to cognitive performance in healthy older adults: International Journal of Psychophysiology Vol 53(2) Jul 2004, 121-125. *Swithers, S. E. (1995). Effects of physiological state on oral habituation in developing rats: Cellular and extracellular dehydration: Developmental Psychobiology Vol 28(3) Apr 1995, 131-145. *Szlyk, P. C., Hubbard, R. W., Matthew, W. T., Armstrong, L. E., & et al. (1987). Mechanisms of voluntary dehydration among troops in the field: Military Medicine Vol 152(8) Aug 1987, 405-407. *Szlyk, P. C., Sils, I. V., Francesconi, R. P., Hubbard, R. W., & et al. (1989). Effects of water temperature and flavoring on voluntary dehydration in men: Physiology & Behavior Vol 45(3) Mar 1989, 639-647. *Taylor, K., Mayer, L. P., & Propper, C. R. (1999). Intra- and extracellular dehydration-induced thirst-related behavior in an amphibian: Physiology & Behavior Vol 65(4-5) Jan 1999, 717-721. *Thornton, S. N. (1986). Drinking in the pigeon (Columba livia) in response to water deprivation and the influence of intracerebroventricular infusions of NaCl or sucrose solutions: Physiology & Behavior Vol 38(5) 1986, 719-724. *Verdolini, K., Titze, I. R., & Fennell, A. (1994). Dependence of phonatory effort on hydration level: Journal of Speech & Hearing Research Vol 37(5) Oct 1994, 1001-1007. *Verelst, S. G. R., Pasman, H. R. W., Onwuteaka-Philipsen, B. D., Ribbe, M. W., & van der Wal, G. (2006). Experiences of family with the decision-making about artificial nutrition and hydration (ANH) for people with dementia in a nursing home: Tijdschrift voor Gerontologie en Geriatrie Vol 37(2) Apr 2006, 51-58. *Vivas, L., & Chiaraviglio, E. (1989). Central effects of agents which alter sodium transport on water drinking in the rat: Brain Research Bulletin Vol 22(2) Feb 1989, 201-206. *Volkert, D., Kreuel, K., & Stehle, P. (2004). "Nutrition beyond 65"--Amount of usual drinking fluid and motivation to drink are interrelated in community-living, independent elderly people: Zeitschrift fur Gerontologie und Geriatrie Vol 37(6) Dec 2004, 436-443. *Watts, A. G. (1992). Osmotic stimulation differentially affects cellular levels of corticotropin-releasing hormone and neurotensin/neuromedin N mRNAS in the lateral hypothalamic area and central nucleus of the amygdala: Brain Research Vol 581(2) May 1992, 208-216. *Watts, A. G. (1999). Dehydration-associated anorexia: Development and rapid reversal: Physiology & Behavior Vol 65(4-5) Jan 1999, 871-878. *Watts, A. G. (2001). Neuropeptides and the integration of motor responses to dehydration: Annual Review of Neuroscience Vol 24 2001, 357-384. *Watts, A. G., Kelly, A. B., & Sanchez-Watts, G. (1995). Neuropeptides and thirst: The temporal response of corticotropin-releasing hormone and neurotensin/neuromedin N gene expression in rat limbic forebrain neurons to drinking hypertonic saline: Behavioral Neuroscience Vol 109(6) Dec 1995, 1146-1157. *Watts, A. G., Sanchez-Watts, G., & Kelly, A. B. (1999). Distinct patterns of neuropeptide gene expression in the lateral hypothalamic area and arcuate nucleus are associated with dehydration-induced anorexia: Journal of Neuroscience Vol 19(14) Jul 1999, 6111-6121. *Whyte, D. G., Thunhorst, R. L., & Johnson, A. K. (2004). Reduced thirst in old, thermally dehydrated rats: Physiology & Behavior Vol 81(4) Jun 2004, 569-576. *Xu, Z., & Ross, M. G. (2000). Appearance of central dipsogenic mechanisms induced by dehydration in near-term rat fetus: Developmental Brain Research Vol 121(1) May 2000, 11-18. *Yawata, T., Okuno, T., Nose, H., & Morimoto, T. (1987). Change in salt appetite due to rehydration level in rats: Physiology & Behavior Vol 40(3) 1987, 363-368. *Yoshimoto, R., Miyamoto, Y., Takahashi, K., Kotani, H., Kanatani, A., & Tokita, S. (2006). Impaired drinking response in histamine H3 receptor knockout mice following dehydration or angiotensin-II challenge: Pharmacology, Biochemistry and Behavior Vol 84(3) Jul 2006, 504-510. External links * * Water requirements in adults * Definition of dehydration by the U.S. National Institutes of Health's MedlinePlus medical encyclopedia * Rehydration Project at rehydrate.org Category:Causes of death Category:Electrolyte disturbance Category:Homeostasis Category:Nutrition Category:Water deprivation Category:Water intake